Healthcare Provider Details

I. General information

NPI: 1619617727
Provider Name (Legal Business Name): ADAM JOSEPH UNGEMACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD STOP 7200
DALLAS TX
75390-4238
US

IV. Provider business mailing address

5323 HARRY HINES BLVD STOP 7200
DALLAS TX
75390-7200
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10092058
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: